Skip to main content
J. Connor Barnhart, MD

Medication Tapering and Deprescribing in San Francisco

7 min readLast updated: 2026-04-20

Psychiatrist-guided, evidence-based medication reduction across multiple appointments – for adults committed to an ongoing tapering plan with medical supervision.

At a Glance

Psychiatric medication tapering in San Francisco with Dr. Connor Barnhart, a board-certified psychiatrist. Ongoing, appointment-based care for adults reducing antidepressants, benzodiazepines, or other psychiatric medications – gradual dose reduction over multiple visits, withdrawal management, and relapse monitoring. Not a one-time consultation or functional medicine visit.

  • A 2024 systematic review and meta-analysis in The Lancet Psychiatry found that approximately 15% of patients experience clinically significant discontinuation symptoms when stopping antidepressants, after adjusting for placebo effects[1]
  • Psychiatric medication discontinuation symptoms typically emerge within 2 to 4 days of stopping and may last 1 to 2 weeks, though they occasionally persist longer without proper medical supervision[2]
  • Current deprescribing guidelines recommend gradual, stepwise dose reductions tailored to individual patient response rather than fixed tapering schedules[3]

Who I Help

Adults in San Francisco and the Bay Area currently taking psychiatric medications who want an ongoing, appointment-based relationship with a board-certified psychiatrist to safely reduce or discontinue those medications over multiple visits. Out-of-network, cash-pay practice; appointments are scheduled in advance.

Patients Wanting to Reduce Medications

People who feel stable on their current regimen and want to explore whether they still need all or some of their psychiatric medications, particularly those who have been on medication for years without re-evaluation.

Common concerns:
  • • Uncertainty about whether medication is still necessary
  • • Previous prescriber never discussed a plan for stopping
  • • Concern about being on medication indefinitely
  • • Difficulty finding a psychiatrist willing to help taper

Patients Experiencing Side Effects

People experiencing bothersome side effects from psychiatric medications such as weight gain, sexual dysfunction, emotional blunting, or fatigue who want to explore reducing dosage or switching to alternatives.

Common concerns:
  • • Side effects affecting quality of life
  • • Feeling emotionally numb or flat on current medication
  • • Weight gain or metabolic changes from medication
  • • Previous attempts to discuss concerns dismissed

Patients Seeking a Therapy-First Approach

People who prefer psychotherapy as their primary treatment and want to use medication only as needed, or who were started on medication in a crisis and now want to transition toward therapy-based management.

Common concerns:
  • • Started on medication during a crisis without a long-term plan
  • • Want to address root causes rather than only manage symptoms
  • • Concerned about long-term effects of medication use
  • • Looking for a psychiatrist who values therapy alongside medication

How I Can Help

Psychiatrist-Supervised Tapering

Medication tapering carries real risks when done without medical oversight. Dr. Barnhart provides physician-supervised dose reduction with regular monitoring for withdrawal symptoms, relapse indicators, and adjustment of the taper pace based on your individual response.

Individualized Tapering Plans

Current research supports gradual, stepwise reductions tailored to the patient rather than one-size-fits-all schedules. Dr. Barnhart develops tapering plans based on the specific medication, duration of use, your symptom history, and your response at each step.

Integrated Therapy Support

As both a psychiatrist and psychotherapist, Dr. Barnhart can provide therapy alongside the tapering process. This is particularly valuable because psychotherapy can help manage anxiety about medication changes and strengthen coping strategies as medication doses are reduced.

Honest Assessment of Whether Tapering Is Appropriate

Not everyone should taper off medication. Some conditions require long-term pharmacotherapy for stability. Dr. Barnhart will give you a straightforward assessment of whether tapering is clinically advisable in your specific case, including the potential risks and benefits.

Holistic Approach to Medication Reduction

Tapering works best when supported by other interventions. Dr. Barnhart's practice integrates psychotherapy, lifestyle optimization, nutritional supplements, and sleep hygiene to support your stability as medication doses are reduced.

My Treatment Approaches

Approaches I use for medication tapering:

PsychotherapyMedication ManagementLifestyle Optimization

Explore More

Related Conditions

AnxietyDepressionInsomnia

Frequently Asked Questions

Medication tapering is the process of gradually reducing the dose of a psychiatric medication over time rather than stopping abruptly. A psychiatrist monitors for withdrawal symptoms and adjusts the pace of reduction based on your response at each step. The goal is to find the lowest effective dose or, when appropriate, to discontinue the medication safely.
Abruptly stopping many psychiatric medications can trigger discontinuation symptoms including dizziness, nausea, insomnia, irritability, and sensory disturbances. Research shows these symptoms can appear rapidly after stopping and may persist. Gradual dose reduction under medical supervision significantly reduces this risk and allows your psychiatrist to distinguish withdrawal from a return of the underlying condition.
The timeline varies depending on the medication, how long you have been taking it, the dose, and your individual response. Some tapers take weeks, others take months. Current clinical guidelines recommend adjusting the pace to your experience rather than following a fixed schedule, slowing down if symptoms emerge and proceeding when you feel stable.
Common withdrawal symptoms include dizziness, nausea, sleep changes, irritability, and sensory disturbances sometimes described as brain zaps. If symptoms become significant during a taper, one common approach is to pause the reduction, potentially return to the previous dose until symptoms resolve, and then resume tapering at a slower pace.
Not necessarily. Some conditions such as bipolar disorder, recurrent severe depression, or chronic psychotic disorders may require long-term medication for stability. Dr. Barnhart will assess your diagnosis, treatment history, and current stability to give you a straightforward answer about whether tapering is advisable in your case. The goal is an informed, shared decision.
Medication tapering at Barnhart Psychiatry is a psychiatrist-guided process for patients who want to safely reduce or adjust their current psychiatric medications. Dr. Barnhart works with you over multiple appointments to develop a gradual, individualized plan – monitoring symptoms and making adjustments along the way. This is not a one-time consultation, and stopping medication may or may not be right for you. If you are currently taking psychiatric medication and want to explore whether a lower dose or alternative medication option might be right for you, request a call to discuss whether Dr. Barnhart's approach fits your situation.
Yes, and that experience actually provides useful information. A difficult previous taper often means the reduction was too fast, the decrements too large, or the timing was not right. Dr. Barnhart can review what happened and design a better approach. Having struggled before does not necessarily mean tapering is impossible; it may mean the method needs to be adjusted.
No. Dr. Barnhart is a board-certified psychiatrist providing evidence-based psychiatric care. The tapering approach draws on deprescribing research from peer-reviewed psychiatry literature and clinical guidelines. Lifestyle support (nutrition, sleep, exercise, selected supplements) complements psychiatric care but does not replace it. If you are looking specifically for a functional medicine practitioner, naturopath, or herbalist to coordinate medication discontinuation with alternative protocols, this is not the right practice for you.
No. Medication tapering requires a full psychiatric evaluation and an ongoing relationship – not phone-based medical advice. All clinical care happens in scheduled in-person or telehealth appointments after an initial comprehensive assessment. The "Request a Call" button on this site is for a brief introductory call with Dr. Barnhart to see whether the practice is a fit – not a clinical consultation or medication advice.
New patients schedule an initial comprehensive assessment (60-90 minutes, $600-$900, prorated by time) with Dr. Barnhart. Tapering plans typically involve multiple follow-up appointments over weeks to months depending on the medication and your response. Follow-ups range from $300 for a 30-minute focused medication visit to $600 for a 45-60 minute holistic visit. This is a cash-pay, out-of-network practice; superbills are provided for out-of-network reimbursement, and HSA/FSA funds are eligible.

Your Practitioner

J. Connor Barnhart

J. Connor Barnhart, MD

Dr. J. Connor Barnhart is a board-certified psychiatrist and psychotherapist practicing in San Francisco. He completed his psychiatry residency at UCSF, where he trained in the Bipolar, LGBT, and Women's Mental Health specialty clinics and developed focused expertise in integrative psychiatry through a year-long rotation at the UCSF Osher Center. He attended medical school at the University of Pennsylvania's Perelman School of Medicine and graduated from Brown University with honors in Human Biology. His practice combines insight-oriented therapy, medication management, supplements, and lifestyle optimization to holistically address the root causes of mental health challenges including depression, anxiety, and difficulties with focus.

Education

  • Sc.B. in Human Biology (Magna Cum Laude) – Brown University
  • MD – University of Pennsylvania, Perelman School of Medicine
  • Adult Psychiatry Residency (2019-2023) – University of California, San Francisco (UCSF)
  • Psychoanalytic Psychotherapy Training Program – San Francisco Center for Psychoanalysis

Professional Affiliations

  • Treasurer, Northern California Psychiatric Society (2021-present)
  • Board Member, California State Association of Psychiatrists (2023-2024)
  • Member, American Psychiatric Association